# MEMORIAL HOSPITAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE MEMORIAL HOSPITAL
- **Other names:** Memorial Hospital EEG Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1386863496
- **Legal business name:** THE MEMORIAL HOSPITAL
- **Authorized official:** MR. FRANCIS R DIETZ (CEO PRESIDENT)
- **Authorized official phone:** (401) 729-2000

## Contact information

- **Practice address:** 111 BREWSTER ST, PAWTUCKET, RI 02860-4400
- **Practice address phone:** (401) 729-2000
- **Mailing address:** 111 BREWSTER ST, PAWTUCKET, RI 02860-4400
- **Mailing address phone:** (401) 729-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084D0003X | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician | — | NULL | Yes |
| 2084D0003X | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician | — | — | Yes |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |

## Other

- **Enumeration date:** 04/25/2007
- **Last updated:** 11/30/2007